Health Committee on Dec. 11th, 2018

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Do you have any recommendations about what ought to be happening in B.C. to cap the supply of meth?

[Chief Danny Smyth]

I'm not familiar with B.C. Certainly border security would come into play. These drugs would be smuggled in containers on transport trucks and ships.

This is certainly not my area of expertise, in the middle of the Prairies.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Chief Barlow, do you have any ideas?

[Chief Steve Barlow]

I'm similar in that way. If we are to tighten up our borders, these are.... The organized crime world is very sophisticated. I would have a serious concern with spending millions of dollars on our borders before spending millions of dollars on supporting the people who are addicted. I'm not saying I would ever say, “Cut my budget”, but I would say that supporting the users.... If we're able to work with them more, doing so is, in my humble opinion, what we need to be looking at spending our money on right now.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

All right.

Dr. Juurlink, you have a comment.

[Dr. David Juurlink]

I'm nodding because I'm in complete agreement.

Like fentanyl, these drugs are not very difficult to synthesize. Even if you could somehow snap your fingers and make our borders impermeable, somebody would make it here. You would see more labs in Calgary than you currently have, because the market is there. It goes back to the whole issue of drug use just being an element of human behaviour.

I think the way to tackle this is not through trying to tackle the supply side. It's trying to tackle the demand side. If you can help the people who are currently using it, most of whom are wanting help, you're going to tackle the supply indirectly.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

That's very good. Thank you.

[The Chair, Liberal, Bill Casey]

Your time is up.

Now, we go to Mr. Ayoub. I imagine that Mr. Ayoub might ask his questions in French, so if you need translation, it's right there for you, I hope.

Mr. Ayoub, you have five minutes.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

I will continue along the same lines as Ms. Gladu, concerning the traffic in narcotics and methamphetamines. Basically, you are not giving us the impression that trafficking can be stopped. So the drugs will either be made in Canada or they will be imported.

You mentioned investing money in research and development in order to find a cure. What is your understanding of the research and development, Dr. Juurlink? Do you think that we should develop a substitute drug that could be given to patients to help them to get out of this vicious circle, as is done with opioids? Is that something you see in your practice and in your research?

[Dr. David Juurlink]

Thanks for your question.

The research could be funded that gets a magic bullet to help address methamphetamine addiction, but I think billions of dollars have already been spent in the U.S. to that end, in particular, to no avail. As I said earlier on, it's quite different from opioids, as your comment implied, so I don't think the answer to this crisis is going to be through finding some magical medication that helps people stop using. There are some drugs, like anti-depressants, Prozac and others that will help reduce cravings in some people, but there are not a lot of drugs.... I think it's unlikely we're going to find one that solves the problem that way.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

You are telling us that there is no replacement solution for this drug. In your opinion, it will always be available and users will basically have no other choice than to be treated for addiction. No medical assistance is possible, other than treatment for addiction.

[Dr. David Juurlink]

I guess it depends on the context. Someone who is using meth to stay awake, like a long-haul trucker, for example, could use something that's safer in the form of Adderall, for example, the drug I mentioned to you earlier. That's not an ideal solution, but it's something that's inherently safer than the stuff that you're buying from a guy, because you don't know what's in it.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you.

I have half my time left. I am going to go back to my colleagues in the Winnipeg and Calgary police services.

Let's not talk about the users, the consumers, of this drug. Let's talk about the dealers. In your opinion, are federal and provincial laws restrictive enough, specifically federal laws on trafficking? Are they strong enough to have an impact on the dealers themselves, and on organized crime?

Dr. Juurlink was talking about legalizing drugs. It has been done for marijuana, but, at the same time, to protect young people, the penalty for the dealers who sell the drug to young people has been increased to 14 years. For this drug, do you feel support from federal laws in terms of getting the criminals out of the market?

[Chief Steve Barlow]

This is very complicated when we get into the dealers' part of this and feeling supported. In my humble opinion, the laws of our land do support our being able to deal with the dealers, but the unknown factor here is that a lot of our serious dealers will use addicts to be their dealers. There's a really fine line between a true dealer, who is the money person and the person who is truly profiting.... They are the difficult ones to get to because of that middle person. You have the user at the bottom and then you have the middle person, who generally is a user, so we are balancing and having a difficult time trying to figure out, on the policing side, whether we are dealing with the true dealer. I think when we get to the true dealers, in what I see, we are being supported by the legislation.

I turn to Collin here because he's in our court system, on a regular basis all the time, so we would like to actually also hear from him.

[Det Collin Harris]

I agree with Chief Barlow in that we are supported to a certain extent. I believe it is often very difficult to obtain successful investigations into individuals who are importing at a wholesale level. A great deal of time and investigative ability and evidence is required in order to successfully prosecute those crimes.

The smaller crimes are a lot easier to do, and unfortunately, we aren't making our way to as many, as you would say, big fish as we would like. Those investigations cost millions upon millions of dollars to carry out and successful prosecution can be very difficult at times. When we do have successful prosecutions, we are getting supported to a certain extent. Some may say we are getting good sentences. Others may say they're not enough, but that's really not for us to decide.

[The Chair, Liberal, Bill Casey]

Time's up. Thanks very much.

You have three minutes, Mr. Davies, and the last question.

[Don Davies, NDP, Vancouver Kingsway, BC]

Dr. Juurlink, does the threat of punishment generally prevent people from using drugs?

[Dr. David Juurlink]

I don't think it does.

[Don Davies, NDP, Vancouver Kingsway, BC]

In your view, is there any substantial credible evidence to support the continuation of the criminalized approach to substance use?

[Dr. David Juurlink]

No, as I said in my comments, I think it's intensely counterproductive.

[Don Davies, NDP, Vancouver Kingsway, BC]

The current federal government has explicitly ruled out decriminalization and regulation of drugs. In your view, will it be possible to meaningfully address the current drug crisis if we're unwilling to consider decriminalization and regulation of supply?

[Dr. David Juurlink]

No. I think there's a lot of talk about harm reduction and I think you can't really have a serious conversation about harm reduction without at least broaching the concept of decriminalization and a regulated supply for the people who are using and are literally at risk of dying today from what they're using.

[Don Davies, NDP, Vancouver Kingsway, BC]

Yes, it's one of the puzzling things I hear in this debate. The government talks about being committed to harm reduction and they talk about supervised injection sites and opioid substitution projects, but isn't decriminalization and regulating the supply of drugs that people get in all quantities the ultimate harm reduction?

[Dr. David Juurlink]

Yes. I can see the argument being lobbed against that, but if you wanted to prevent people from dying from drug use, that would be the most effective way to do it, and guiding them, those who are ready, into treatment, provided treatment is there, whether they want treatment themselves or are referred by family, or from the emergency department or from the police.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have a final question. You made a reference to alcohol being a drug, and now we have cannabis. We've legalized alcohol and cannabis. Is there any principled medical or sociological reason to treat other forms of drugs, whether it's methamphetamine or opioids, in a different legal structure from a policy point of view?